Economics of using pharmacists as advisers to physicians in risk-sharing contracts

An educational program designed to help physicians control the overall cost of drugs and total health care is described, along with its effectiveness at one managed health care plan. Prime Therapeutics, Inc., developed and manages an ongoing physician educat ion program designed to help primary care physicians control drug and total health care costs. Physician education initiatives in the program are deve loped by using peer-reviewed literature; selections of preferred drugs are based on evidence of their safety, efficacy, uniqueness, and cost-effective ness. For a typical educational initiative, a pharmacist meets with the phy sicians identified as being among the top 20% of prescribers of high-cost d rugs addressed by the initiative and delivers a 20-minute presentation. One -on-one meetings with the physicians are then held quarterly to review thei r prescribing. Each physician is shown comparisons with the prescribing pat terns of other physicians in the organization. The clinic chooses to presen t the clinicwide data as either blinded or nonblinded data. The program was evaluated by comparing per member per month (PMPM) total health care and d rug costs for 1996 and 1997 at 12 general medicine clinics in a managed hea lth care plan. Five clinics received no interventions, three clinics allowe d the initial presentation and the quarterly face-to-face meetings, and fou r clinics allowed only the presentation and barred ongoing meetings. In gen eral, the clinics with more interaction between pharmacists and physicians had lower PMPM costs for total health care and drugs than the clinics with less interaction. Pharmacists acting as advisers to primary care physicians in general medici ne clinics helped lower PMPM costs for drugs and total health care.